More effective water management might have prevented most of the Legionnaires’ disease outbreaks the Centers for Disease Control and Prevention investigated from 2000 through 2014, according to a report in CDC Vital Signs.

Problems identified in these building-associated outbreaks included inadequate disinfectant levels, human error, and equipment breakdowns that led to growth of Legionella bacteria in water systems. CDC officials released a new toolkit today to help building owner and managers prevent these problems. 

In the last year, about 5,000 people were diagnosed with Legionnaires’ disease and more than 20 outbreaks were reported to CDC officials. 

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“Many of the Legionnaire’s disease outbreaks in the United States over the past 15 years could have been prevented,” CDC Director Tom Frieden, MD, MPH, said in a statement. “Better water system management is the best way to reduce illness and save lives, and today’s report promotes tools to make that happen.”

The Vital Signs report examined 27 building-associated Legionnaires’ disease outbreaks investigated by CDC across 24 states and territories, Mexico, and Canada. For each outbreak, CDC researchers recorded the location, source of exposure, and deficiencies in environmental control of Legionella.

The most common source of building-associated Legionnaires’ disease outbreaks was drinkable water (56%), such as water used for showering, followed by cooling towers (22%), and hot tubs (7%). Other sources included industrial equipment (4%) and a decorative fountain/water feature (4%). In two outbreaks, the source was never identified.

Twenty-three of the investigations included descriptions of failures that contributed to the outbreak.

“Years of outbreak response have taught us where to find Legionella hot spots,” Nancy Messonnier, MD, director of CDC’s National Center for Immunization and Respiratory Diseases said in the statement. “The toolkit will help building owners and managers better understand where those hot spots are and put measures in place to reduce the risk of Legionnaires’ disease.” 


    CDC. Developing a Water Management Program to Reduce Legionella Growth & Spread in Buildings: A Practical Guide to Implementing Industry Standards